Professional Competencies - Half Hard, Half Soft

     "Professional competencies in medicine are physician skills defined (by Epstein & Hundert) as the 'habitual and judicious use of 1) communication, 2) knowledge, 3) technical skills, 4) clinical reasoning, 5) emotions, 6) values, and 7) reflection in daily practice for the benefit of the individual and community being served.' Students are expected to graduate with a working knowledge of these competencies in place."

       Walcher ME. A look in the mirror: Self-development and transformational learning in medical students. Dissertation Abstracts International Section A: Humanities and Social Sciences 2013; 73: 8-A.

       Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA 2002; 287(2): 226-235. 

     Of the 7 competencies, how much of our time & effort do we devote to #'s 1, 5, 6 & 7?
    ... "And how's that working for us?"

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We Embody & Teach Our Current Level of Consciousness, for Better or Worse

     "role modeling is the most common form of teaching values, ethics, and the human dimensions of care.

     Unfortunately, the demonstration of undesirable behaviors & attitudes is also effective. Such 'negative role modeling' has been documented to produce unprofessional behavior and even ethical erosion during clinical training. Sometimes referred to as a 'hidden curriculum,' such negative role modeling can be understood as a pattern of behaviors prevalent in a group that runs contrary to the desired & explicitly stated attitudes & behavior of humanistic care. Further, this hidden curriculum undermines the curricular objectives of courses on professionalism, ethics, and 'the art of medicine' that are usually taught during the first two years of medical school.

     Given the pervasiveness of negative attitudes & nonhumanistic behavior, we believe proper role modeling is an important teaching method by which to counter the hidden curriculum modeled by others. 

     How do master clinical teachers develop their teaching skills with respect to the human dimensions of care? In postencounter interviews, the faculty indicated that they use personal self-reflection to develop their teaching skills. Reflective practice has been recognized as an important element of professional development. For the faculty in our study, self-reflection was an iterative process that continued throughout their teaching careers."

       Weissmann PF et al. Role modeling humanistic behavior: learning bedside manner from the experts. Acad Med 2006; 81(7): 661-7.

      It may be safe to assume that those who manifest 'negative role modeling' are much less self-reflective, have minimal awareness of their poor intra- & inter-personal skills, and likely value technical knowledge over communication and other relational ("soft") skills.

     "Physician, Know Thyself!"

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